ArticlePulmonary circulation2026
4D-Flow MRI-Derived Wall Shear Stress as a Non-Invasive Biomarker for the Detection and Hemodynamic Characterization of Pulmonary Hypertension.
Article in Pulmonary circulation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Invasive right heart catheterization (RHC) remains the reference standard for diagnosing pulmonary hypertension (PH), but there is a pressing need for non-invasive techniques to assess pulmonary hemodynamics. This study evaluates 4D-flow MRI-derived wall shear stress (WSS) for PH detection using the updated 2022 hemodynamic criteria, and the prediction of right ventriculo-pulmonary arterial (RV-PA) uncoupling to assess disease severity. 3D WSS was measured in the main (MPA), right (RPA), and left (LPA) pulmonary arteries in a retrospective validation cohort (41 PH patients, 23 non-PH) and then assessed in a prospective test cohort (23 PH patients, 17 healthy controls). For methodological validation, a patient-specific computational fluid dynamics (CFD) was performed in a subset of 16 patients from the validation cohort. RV-PA uncoupling was assessed on the cine MRI, using RV global longitudinal strain (GLS) < -15.3% and RVSV/RVESV < 1. Both 3D peak and time-averaged WSS were significantly reduced in PH patients compared with healthy controls. Global WSS metrics demonstrated the strongest correlations with invasive hemodynamic parameters, including mPAP (
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